BROAD PARK IMAGING, LLC (NPI# 1467782052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467782052 |
| Entity Type | Organization |
| Organization Name | BROAD PARK IMAGING, LLC |
| Practice Address |
1750 Broad Park Cir S Suite 300 Mansfield TX 76063-7832 |
| Practice Telephone | 6822002517 |
| Practice Fax Number | 6822002518 |
| Mailing Telephone | 6822002517 |
| Mailing Fax Number | 6822002518 |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |
| Authorized Official Name | JACKI BAILLEU (ADMINISTRATOR) |
| Authorized Official Telephone | 8176908873 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Street Address |
1750 BROAD PARK CIR S SUITE 300 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-7832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871820423 | Breast Diagnostics, Pa | Specialist | 1750 Broad Park Cir S, Suite 300, Mansfield, TX 76063-7822 | 2009-11-03 |
| 1497198147 | Elite View Imaging, LLC | Clinic/Center | 1750 Broad Park Cir S, Suite 300, Mansfield, TX 76063-7832 | 2013-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396743191 | Envision Radiology of Texas Lp | Clinic/Center | 710 Hunters Row Ct, Mansfield, TX 76063-4001 | 2005-07-14 |
| 1497198147 | Elite View Imaging, LLC | Clinic/Center | 1750 Broad Park Cir S, Suite 300, Mansfield, TX 76063-7832 | 2013-04-12 |
| 1457566853 | Mansfield Regional Imaging Consultants Corporation | Clinic/Center | 1456 Park Ave W Ste M, Mansfield, OH 44906-2700 | 2007-05-11 |
| 1821141102 | Mansfield Imaging Center LLC | Clinic/Center | 536 S Trimble Rd, Suite A, Mansfield, OH 44906-3418 | 2007-01-19 |
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|---|---|---|---|---|
| 1013515428 | Medical Referral Services, LLC | Clinic/Center | 2450 Nasa Pkwy Ste 125, Houston, TX 77058-3784 | 2020-10-16 |
| 1275144750 | Midland Imaging Center, LLC | Clinic/Center | 2106 N. Midland Dr., Ste 101, Midland, TX 79707-5503 | 2020-08-10 |
| 1134738453 | Origin Mri and Diagnostics | Clinic/Center | 9135 Katy Fwy Ste 102, Houston, TX 77024-1636 | 2020-07-23 |
| 1538777123 | Lexington Medical Imaging, LLC | Clinic/Center | 15925 Lexington Blvd, Sugar Land, TX 77479-2314 | 2020-07-20 |
| 1871101899 | Blue Star Imaging Sa, LLC | Clinic/Center | 112 Herff Rd, Boerne, TX 78006-2747 | 2020-07-15 |
| 1396362836 | Parkhill Imaging Clearfork LLC | Clinic/Center | 5656 Edwards Ranch Rd Ste 100, Fort Worth, TX 76109-4136 | 2020-07-01 |
| 1891319083 | Parkhill Imaging Addison LLC | Clinic/Center | 17051 Dallas Pkwy Ste 200, Addison, TX 75001-7119 | 2020-06-03 |
| 1669093779 | Hi Tech Imaging, LLC | Clinic/Center | 423 Sw Military Dr, San Antonio, TX 78221-1654 | 2020-04-29 |
| 1861027120 | North Star Mcd, LLC | Clinic/Center | 3700 W 15th St Bldg D Ste 200, Plano, TX 75075 | 2020-03-06 |
| 1740814029 | Venus Mri & Women's Center, LLC | Clinic/Center | 24721 Tomball Pkwy Ste 150, Tomball, TX 77375-7727 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.